Subpoena To Testify Form
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1DEPARTMENT OF REVENUE
Enforcement Group
HEARINGS DIVISION
1881 Pierce Street
Entrance B, Room 106
Lakewood, Colorado 80214-1493
Phone (303) 205-5606
FAX (303) 205-5700
SUBPOENA TO TESTIFY
In the matter of the driving privilege of:
__________________________________
________________________
Respondent
Case Number
To:
You are hereby directed to appear
by telephone
in person at a hearing before the Colorado Department of
Revenue, Hearings Division at :
On
Date:
Time:
YOU MUST TAKE THE FOLLOWING ACTION:
If your appearance is by telephone, you must contact the Hearings Division at 1-855-813-5221 at least ten (10) minutes prior to
the scheduled hearing and provide a telephone number where you can be reached for the hearing. A Hearing Officer will contact
you at that number. Your failure to provide a contact number, or failure to be available when called, may result in a
default of the case and contempt proceedings against you through the District Court.
You are also required to produce the following documents:
If you are appearing in person, bring the documents with you to the hearing. If you are appearing by telephone, the documents
may be faxed or mailed, but must be received by the Hearings Division at least three (3) days prior to the hearing.
This subpoena was issued on the application of:
**If this subpoena is for other than the appearance of the officer who signed the Affidavit and Notice of
Revocation, complete the required statement attachment.
By: (Hearing Officer)
Date
AFFIDAVIT OF SERVICE
the Affiant, being duly sworn, says: That he/she is over the age of eighteen years and is not a party to
______________________
this action: and that Affiant has personally served this within subpoena in the City of ____________________, County of
__________________, State of Colorado by handing a copy of same to _____________________________(name of person),
who has been identified as __________________ (title of person) on _______________(date), at _____________a.m./p.m., and
paid the witness fee(s) as follows:
WITNESS FEE
$ ______________
(If applicable pursuant to §24-4-105(5) C.R.S.)
MILEAGE FEE
$ ______________
(If applicable pursuant to §13-33-103 C.R.S.)
TOTAL
$ ______________
Subscribed and sworn to before me this _____day of _________, 20____ in the County of _____________, State of Colorado
Notary______________________________________________
My commission expires _______________
_____________________________________
Affiant
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